Characteristics for Predicting Long-Term Pediatric Asthma Outcomes

In children with asthma, adverse clinical outcomes are affected by the child’s baseline levels of serum immunoglobulin E (IgE), blood eosinophils, and allergen sensitization. Additionally, allergen sensitization and inhaled corticosteroid (ICS) dosage were predictive of long-term clinical outcomes. These were among the finding of a study recently published in Pediatric Research.

Few longitudinal studies exist for pediatric asthma that measure the association between asthma severity and various clinical characteristics. Investigators sought to determine longitudinal outcomes related to pediatric patients’ total IgE, blood eosinophils, allergen sensitization, and ICS dosage. To accomplish this, investigators conducted a retrospective study from September 2004 to December 2018 of 699 patients with childhood asthma at the National Taiwan University Hospital. The study included 1 cohort with 383 patients with data on total serum sensitization and percentage of blood eosinophil, and a validation cohort of 313 patients with data for percentages of blood eosinophil only. During follow-up, researchers collected clinical outcome data on peak expiratory flow (PEF) variability, PEF predicted percentage, asthma severity, and asthma control.

Data revealed that increased asthma severity had been significantly associated with the percentage of blood eosinophils (odds ratio [OR]: 1.043; 95% CI: 1.002–1.086; P =.0392), and with mold sensitization (OR: 2.2485; 95% CI: 1.3253–3.8150; P =.0027). Sensitization status and ICS dosage had the best area under the receiver operating characteristic curve value for predicting PEF predicted percentage (0.6609), PEF variability (0.6885), asthma severity (0.5918), and asthma control (0.6441) over time.

Researchers said their findings indicated that over time, the risk for adverse clinical outcomes in children with asthma varied by serum IgE, blood eosinophil, and allergen sensitization, and that long-term clinical outcomes were predictive with sensitization and ICS dosage. “Given the paucity of data on the longitudinal impact of blood eosinophils on asthma outcomes and the emergence of new therapies (anti-interleukin-5 monoclonal antibodies) our data on blood eosinophils is potentially valuable,” the investigators concluded.

Reference

Lee JH, Lin YT, Chu AL, et al. Predictive characteristics to discriminate the longitudinal outcomes of childhood asthma: a retrospective program-based study. Pediatr Res. Published online January 24, 2022. doi:10.1038/s41390-022-01956-6